MEDICARE: BOYD'S PHARMACY OF PEMBERTON, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	3122683	OTHER		NCPDP NUMBER

General Provider Information

NPI Number	:	1851301659
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BOYD'S PHARMACY OF PEMBERTON, INC.

Provider Business Mailing Address
First Line	:	17 FORT DIX RD
Second Line	:
City	:	PEMBERTON
State	:	NJ
Zip	:	08068-1439
Country	:	US
Telephone Number	:	609-894-8288
Fax Number	:	609-894-2225

Provider Business Practice Location Address
First Line	:	17 FORT DIX RD
Second Line	:
City	:	PEMBERTON
State	:	NJ
Zip	:	08068-1439
Country	:	US
Telephone Number	:	609-894-8288
Fax Number	:	609-894-2225

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	MR. THOMAS F GRECO
Credential	:
Telephone Number	:	609-894-8288

Provider Enumeration Date	:	08/08/2006
Last Update Date	:	10/02/2024

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